Two Decades of Laparoscopic Adrenalectomy: 326 Procedures in a Single-Center Experience.

AIM: Aim of this study is to evaluate the results of 20-year single-center laparoscopic adrenalectomy (LA), with different transperitoneal techniques.

MATERIALS AND

METHODS

Three hundred twenty-six adrenalectomies were performed from 1993 to 2013 using a transperitoneal approach through anterior access, flank access, and anterior submesocolic access (adopted by the author for left LA since 2004).

RESULTS

Overall 142 men and 184 women (mean age 59.3 y) underwent 196 right, 113 left, and 17 bilateral adrenalectomies. There was 1 fatal outcome (0.30%) due to sepsis. Conversion to open surgery was required in 7 patients (2.14%) for intraoperative bleeding (n=5), paroxysmal hypertension during pheochromocytoma removal (n=1), and tearing of the colon during bilateral adrenalectomy in a patient with Cushing hyperplasia (n=1).There were 15 postoperative complications (4.60%) managed conservatively.

CONCLUSIONS

Transperitoneal LA is a safe, minimally invasive procedure ensuring early recovery. The submesocolic access is faster and minimizes surgical dissection.